Over years, many clinical and biochemical parameters have suggested predicting liver transplantation survival. Our experience showed that pre- and post-op ascites are two major predictors of liver transplantation outcome.
Methods: Information obtained from liver transplant data registry of Shiraz organ transplant center, Namazee hospital. Pre-op ascites was confirmed with two sonography reports. Post-op ascites was also detected with serial sonographies during hospital stay. Early mortality and late survival rates were compared between subjects with pre-op or post-op ascites with others. Data analyzed by SPSS 13 package and survival rates were calculated by Kaplan-Meier test. Logistic regression test was used to predict mortality rates.
Results: 246 patients were enrolled in our study. Early (3 months) and late (75 months) survival rates in patients without and with preop ascites were 95.3% v/s 70% (p<0.05). No significant difference was seen in graft function, IV fluid administration, CVP, and hemodynamic status of patients with or without pre-op ascites, in their post-op period. Variables such sex, age, Child score, donor liver steatosis, early and long-term rejection episodes, and viral markers did not have any effect on survival. In stepwise logistic regression model, pre-op and post-op ascites predicted mortality of patients with Odd's Ratio=16.9 and 8.6 respectively. Ascites is one of the major predictive factors of hospital mortality and early and late survival of liver transplantation.